Victim, Survivor, Thriver

Trauma is typically understood as occurring when a person's ability to manage events in her or his life is overwhelmed by a particularly challenging or unfamiliar negative event. Traumatic events can include, but are not limited to, natural disasters, acts of terror, rape, incest, gang violence, domestic violence, and sexual assault. In many of these situations, past coping responses are compromised, rendered useless, or perceived as ineffective. The effects of trauma can last over long periods, waxing and waning at different points. Assumptions of invulnerability, the world as meaningful, and the self as competent are challenged. Psychological needs of safety, trust, esteem, intimacy, and control are under assault.

The human reactions to extreme adversity, when plotted on a graph, produce a bell-shaped curve. On the left side are people who fall apart and are prone to depression, anxiety, posttraumatic stress, addiction, and relationship dissolution. In the center, individuals gradually feel less suffering and more moments of joy and normalcy. To the right, we find a large number of resilient individuals who show posttraumatic growth following the typical period of sadness and vulnerability. There has been increased interest in understanding the responses of those who thrive, challenging us to further differentiate traumatic responses.

Varied and wide-ranging, traumatic responses encompass emotional, cognitive, physiological, behavioral, and interpersonal areas of functioning. One can conceptualize the process as three distinct coping responses or as a transformative journey from victim, to survivor, to thriver. Both imply the task of resilience and may compel an individual to process, integrate, and categorize traumatic experiences. Understanding the breadth of traumatic responses has been helpful to aid healing as well as in identifying relevant and clinically or empirically sound approaches to treatment.